Pion B, Valyi Z S, Janssens X, Koch P, Libert J, Caspers L, Willermain F
Bull Soc Belge Ophtalmol. 2013(322):55-61.
To evaluate the causes and success rates of pars plana vitrectomy (PPV) in uveitis patients.
Retrospective study of the charts of 26 uveitis patients (28 eyes) who underwent PPV between the years 2008 and 2011. We examined surgical indications and success rates, based on visual outcomes, complications and diagnosis in case of vitreous biopsy.
(1) Therapeutic PPV (TV) was performed in 36% of the eyes, (2) TV combined with epiretinal membrane (ERM) peeling in 21% and (3) diagnostic PPV (DiV) was performed in 64% of the eyes. Eight eyes (28,6%) underwent a combined cataract and vitreous surgery. Visual acuity (VA) improved in 16 eyes (57%), with a mean improvement of -0,9 log of the minimum angle of resolution (logMAR), although the effect was transient in 7% of the cases. VA remained stable in 11 eyes (39%) and decreased in 1 (4%). Post-operative complications were cystic macular oedema (CMO) in 3 eyes (11%), cataract in 5 eyes (18%) and retinal detachment in 2 eyes (7%). Diagnostic tests were performed in 18 eyes with a success rate of 55%.
In our series of patients with uveitis, a good andstable improvement of VA was found when PPV was performed with ERM peeling while the effect on VA was more transient in the other cases. A good success rate of diagnosis was also found in DiV. However, considering the possible severe complications, diagnostic vitrectomy should be limited to selected cases.
评估葡萄膜炎患者行玻璃体切割术（PPV）的原因及成功率。
回顾性研究2008年至2011年间接受PPV的26例葡萄膜炎患者（28只眼）的病历。我们根据视力结果、并发症以及玻璃体活检时的诊断情况，对手术指征和成功率进行了检查。
（1）36%的患眼进行了治疗性PPV（TV），（2）21%的患眼进行了TV联合视网膜前膜（ERM）剥除术，（3）64%的患眼进行了诊断性PPV（DiV）。8只眼（28.6%）接受了白内障与玻璃体联合手术。16只眼（57%）的视力（VA）得到改善，平均最小分辨角对数（logMAR）改善了-0.9，不过7%的病例中效果是短暂的。11只眼（39%）的VA保持稳定，1只眼（4%）的VA下降。术后并发症包括3只眼（11%）出现黄斑囊样水肿（CMO），5只眼（18%）出现白内障，2只眼（7%）出现视网膜脱离。18只眼进行了诊断性检查，成功率为55%。
在我们的葡萄膜炎患者系列中，当PPV联合ERM剥除术进行时，发现VA有良好且稳定的改善，而在其他情况下对VA的影响更短暂。DiV的诊断成功率也较高。然而，考虑到可能出现的严重并发症，诊断性玻璃体切除术应限于特定病例。
